Quote:
Originally Posted by markg91359
I really ought to quit right here, Mircea. This is such a bizarre and ridiculous statement you've destroyed any little credibility you might have. No rebuttal is necessary at all. Its just a stupid statement.
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And you're evidence is what?
The American Hospital Association did not form a committee to dictate to member hospitals plan specifics and minimum requirements for pre-paid hospitalization plans in 1943?
Yes, they did. It is a matter of historical fact.
The American Hospital Association did not lobby the IRS and the National War Labor Board regarding the decision to classify pre-paid hospitalization plans as "fringe benefits" not subject to taxation?
Yes, they did. It is a matter of historical fact. Read the War Labor Reports. What do you think "...
on the recommendation of..." means? What, you thought the War Labor Board picked up the telephone and said,
"Hello, Operator, get me Bensonhurst 549.....Hello? American Hospital Association? We have a bit of a poser and don't know what to do. What do you recommend?"
No, the AHA was already in their face 24/7.
The aforementioned committee did not become the Blue Cross in 1946?
Wrong, answer it did. That's a fact.
The American Hospital Association did not lobby for additional tax subsidies?
Yes, they did. It's historical fact.
The American Hospital Association did not lobby State legislatures to enact legislation mandating requirements for pre-paid medical plans?
Yes, they did. Go read about it.
The American Hospital Association did not lobby Congress for passage of the ACA and did not write sections of the ACA?
Wrong, they most certainly did.
In fact, if I'm not mistaken, the president of the AHA was with Obama at the "signing ceremony" for the ACA.
The American Hospital Association was also a major donor to the Obama 2008 Election Campaign. I can't speak to 2012, because I don't know, and I don't really care.
And so you're naive enough to believe that while Congress contemplates some kind of national health care system, the American Hospital Association is going to saunter off and take a nap?
Quote:
Originally Posted by markg91359
Your point about the obligations of these systems to render only "medically necessary care" doesn't surprise me. Read through your health insurance policy sometime. You'll likely find language in the policy that only obligates your private insurer to pay for "reasonable and medically necessary expenses". These are legal terms.
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You don't understand. I'll let the German Minister of Health explain it to you....
"By law, our health insurers cannot reimburse for services that are deemed unnecessary. Thus, a doctor who provides such services will not be paid for them. If IQWiG (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) decides that a given treatment does not provide value, the treatment can be excluded from the benefits package". -- Franz Knieps German Minister of Health (2009)
....see the difference?
We aren't talking about safety aspects here. This is not the same thing as getting FDA approval for a drug, or AMA approval for a medical procedure or medical treatment plan.
We're talking about drugs and medical procedures that have been approved for use, but which the German (and other governments) deem to be of no value, because of low success rate or other reasons.
In other words, you can get those drugs or medical procedures, but the government will not pay for them. You must pay out-of-pocket or get supplemental insurance. Why do you think more than 50% of Danes have supplemental insurance? To cover drugs and medical procedures that the government will not pay for.
European countries have two forms of VHI (Voluntary Health Insurance).
The first is Complimentary VHI, which covers services excluded or not fully covered by the government. The second is Supplementary VHI allowing faster access and more choice.
Quote:
Originally Posted by markg91359
If you believe the free market is capable of fixing our health care problems in a manner that is acceptable to a majority of American people it is you who lives in a "fantasy world".
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Got any facts?
No, of course not.
You have not had a Free Market health care system since 1943 when the American Hospital Association interfered and forced member hospitals to provide specific items and minimum requirements for pre-paid hospitalization plans ---- the forerunner of your present pre-paid medical service plans (and that is technically and legally what it is, a pre-paid plan and not insurance).
Those are quotas.
What is really bizarre is that you condemn a system to which you have never been exposed and have never seen in operation.
For the very brief time in American history when you had Free Market health care,
it worked.
Quote:
Originally Posted by markg91359
Europe and the other developed countries have that figured out.
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No, they did not. They always had socialist/government style systems.
And they are moving toward private health care, albeit very slowly, since they have no choice...they can't fund it.
Not impressed with pedantic musings...
Mircea
Quote:
Originally Posted by Grim Reader
The German health care system costs 2/3rds of the US one, and in fact cme in a surplus of 5 billion. How is making sure that the system balances its income and outgoings bad?
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You just don't get it.
"In the past 20 years, our overriding philosophy has been that the health system cannot spend more than its income." -- Franz Knieps German Minister of Health (2009)
If the German system was like pizza in the US, the only thing you could get is cheese or pepperoni, but not both cheese and pepperoni. If you want cheese and pepperoni, then you have to get private insurance -- VHI -- and how do you do that?
Germany:
Pre-existing conditions are excluded if they were known at the time of underwriting and were not disclosed by the insured; declared pre-existing conditions are covered but generally result in higher premiums.
That's from the European Observer on Health Systems and Policies (Spring 2004 Volume 6, Number 1).
[emphasis mine]
What were you rambling about?
This is not the first time you and I have discussed costs, and clearly you're not getting it.
European health care is cheaper, because the homogenous nation-States spend less, and the reason the homogenous nation-States spend less, is because the homogenous nation-States budget less money on health care.
It's like having an house at that needs $11,000 worth of repairs, you budget and spend $4,000 and they say what a great job you did.
Yeah, well, $7,000 worth of repairs were never effected.
Tensions over the Canadian model centre on provincial governments’ concerns regarding rising levels of public spending. From the public’s perspective the issue is wait-times, which have been a problem since the mid 1990s when there were significant cuts in Medicare (Tuohy, Flood & Stabile, 2004).
Virtual budgets are also set up at the regional levels; these ensure that all participants in the system—including the health insurance funds and providers— know from the beginning of the year onward how much money can be spent. ---- Franz Knieps, German Minister of Health 2009
If you still don't get it, then I guess you never will.
Quote:
Originally Posted by Grim Reader
Um...what? The US rationing is the hardest and most ferocious in the developed world! It just rations by insurance and ability to pay rather than medical need. Which explains a lot of the poor performance...
81 million people are uninsured or underinsured in the US. 25 % of the population (Health Affairs, Sept. 2011 30(9): 1762–71.) And medical care is not rationed!? How is that not a more severe rationing than anywhere in the first world?
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I gave the definition of rationing 1 or two posts earlier. Ah, here it is.....
Rationing exists when...
1] Scarcity of physical resources and a perceived need for their allocation
2] Waiting lists and long waiting times
3] Denial of treatment
4] Discrimination between patients regardless of need
Those definitions stem from....
Allocating resources when their supply is limited (EIU Healthcare International)
The displacement of the interests of one group of patients by another (Spiers, J.,
The Realities of Rationing: ‘Priority Setting’ in the NHS, London)
How many of a given intervention will be provided, to whom, at what cost, and under what circumstances (Rationing Health Care, Brit. Medical Bull. 51)
Die kuenstliche Verknappung eines durchaus vorhandenen Angebots --- The artificial curtailment of supply when it is actually available (Cueni, T.,
Rationalisieren oder Rationieren?)
The point is that we don't make up definitions to suit ourselves.
Quote:
Originally Posted by Grim Reader
The US spends 8 000 per person. 5 000 is the high end of what the US is estimated to spend with a UHS system. Almost 40 % less than todays costs.
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No, the US does not spend that much.
The US spends $13,000+ on Medicare recipients, but they old skins use a lot of health care.
The US spends an average of $5,737 per veteran, but then that, like the old skins, is a special group of the population.
Average Medicaid expenditure in 2010 was....
Children: $2,848
Adults: $4,123
Blind/Disabled: $16,563
Aged: $15,678
Total: $6,890
Page 13, Medicaid 2010 report.
This is a debate, bring some facts next time.
Quote:
Originally Posted by Grim Reader
The true cost is clearly not 5000, since these countries get better resuts for less than that. By definition. It is almost like you think the US is the norm and not the outlier.
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They do not get better results.
As mentioned earlier, the issue is metrics. As the Center for Disease Control pointed out in an earlier link I gave, if the US adopted the same metrics that Sweden uses, then the US is #5 in the world in infant mortality, and that would leave like 3 points separating the US from #1 (points being 1/10th of 1%).
Quote:
Originally Posted by Grim Reader
Economics of scale works to the advantage of the bigger player. That is why Wall-Mart and Starbucks outcompete the mom-and-pop stores. The fact that the US has more people means it should be able to do it cheaper and better. Thats what "economics of scale" means.
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Only up to a point. Also, um, Wal-Mart engages in
monopsony. So does Starsucks.
I'm guessing you either don't wear Levi's jeans, or you never noticed the difference in the color of the tags.
Many companies now produce a
lesser quality good exclusively for sale at Wal-Mart in order to meet Wal-Mart's dictatorial price schemes. After watching 10 manufacturers/suppliers go into bankruptcy, they figured out who to beat Wal-Mart at their own game.
Walmart wants to pay $1 for an item that costs $6 so they can sell it for $10 and make a $9 profit.
The trick is to sell Wal-Mart a lesser quality item that costs $1, instead of $6.
Study your economics a little more.
Quote:
Originally Posted by Grim Reader
And having 25 % of the population unisured and underinsured is not worse than having 1-2 % on a waiting list?
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What I'm hearing is that you want to destroy the US economically so you can feel good about people having insurance.
Why don't you insure them? You can pay for their insurance? Why don't you?
I have a better idea --- go back to 1939 when everyone could afford a pre-paid hospitalization plan and all plans were individual-based, and your employer was not involved.
What's wrong with that?
I noticed that no one addressed paying for a national health care system. I can see why they wouldn't.
Britain taxes about 40% of its national income and dedicates some 15% of that to the NHS.....except 15% isn't enough and health care is denied, delayed or diluted.
Sweden taxes 58% of national income, of which 11% is spent on public health services.
Spain funds theirs with a 15% tax on the first Euro 43,000 in earnings.
The Netherlands has your annual insurance premium, then you pay 6.5% up to first Euro 30,000 and then in addition, everyone pays 13.45% on the first Euro 36,000 for the extraordinary care fund.
Also, I would point out that in other countries all income is taxable. That is not true in the US where both employers and employees have been shielded from the true cost of health care ever since 1942 when the IRS and National War Labor Board ruled it to be a "fringe benefit."
In other words, your monthly premiums? You pay Social Security, Medicare, IRS and all other taxes on that, plus you and your employer would be responsible for all taxes on the employer part of your contribution.
For those who still don't get it, suppose you paid $2,800 year in premiums and your employer paid $3,200 per year in premiums. That $6,000 is now taxable.....you pay taxes on that....all taxes....to the city/county, State, IRS, FICA, HI and everything else, and so does your employer.
That's how it works in other countries. And if that $6,000 puts you in an higher bracket, or into AMT territory, I'm real sorry about your luck.
Health Care Trivia: The National Health Service (NHS) in the United Kingdom, which employs more than 1.5m people nationwide, is the 4th biggest employer worldwide.
Oh ---- decision-making --- read this paper...
DISCUSSION PAPER
NUMBER 4 - 2004
Department "Health System Financing, Expenditure and Resource Allocation" (FER)
Cluster "Evidence and Information for Policy" (EIP)
In Austria, there are three decision makers in the healthcare sector:
a. Federal Government
b. Laender (9 Austrian regions)
c. Authorized civil society organizations
In Italy as well, there are three responsible parties:
a) National level
b) Regional level
c) Local level
That's pretty much how it works for all Euro-States. Austria and Germany are identical.
Why? Oh, yeah, the budget thing.
So they set aside money for health care during the fiscal year, that money trickles/filters down to subordinate government levels, and then into the health care system, where health care is the rationed until the money runs out, then they do it all again the year after.
Is anyone ever going to bring some facts to this debate, or am I the only one?
Wondering...
Mircea
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The history of U.S. attempt at government run healthcare
But we need to be sure some of that money goes back into capital improvement, equipment replacement, etc. That works for all our good.
